Outbreaks of flu can occur in health settings because the virus is so contagious.

A new report said uptake of the vaccine among staff was just 22.5pc in hospitals and 26.6pc in nursing homes.

The HSE had set an uptake target of 40pc for health staff.

"This also means the 75pc target goal for flu vaccination coverage in all at-risk groups, including people with illnesses which leave them prone to the virus, is as remote as ever," the report from experts in the Health Protection Surveillance Centre warned.

Some people are more likely to develop potentially serious complications from flu, such as bronchitis and pneumonia.

Vaccination

The absence of vaccination policies in nursing homes may reflect a "chronic lack of awareness at senior management level about their worth in tackling infection control and reducing the risk of outbreaks of disease among residents", the report warned.

The take-up was highest in children's hospitals, the Dublin Midlands group and the RCSI group in the north-east.

It was lowest in the west and south-west hospitals.

Staff who were quizzed on the reasons for not getting the vaccine cited personal choice, while others said they were allergic to the jab. Others questioned its effectiveness.

The HSE said its current position was that the flu vaccine was recommended for all staff and was "therefore optional".

In both hospitals and nursing homes the uptake was highest among medical and dental staff and lowest among nurses.

This is consistent with a pattern seen in other winters.

There were 75 reported deaths from flu last year, although the real number was much higher.

In England, about 50pc of staff get the flu vaccine, while in the US it is as high as 66.7pc.